If beneficiaries are entitled to Department of Veterans Affairs (VA) benefits, they may choose whether to see a TRICARE or VA provider.
If beneficiaries are entitled to Medicare Part A due to age or another reason, they are considered Medicare-eligible and must have Medicare Part B to keep their TRICARE benefit. Certain beneficiaries may not need Medicare Part B to keep their TRICARE benefit. Learn more
TRICARE beneficiaries with Medicare Part A and Part B are covered by TFL, TRICARE’s Medicare-wraparound coverage. Under TFL, Medicare acts as the primary insurance, and TRICARE acts as the secondary payer.
Medicare does not cover VA care, so if beneficiaries seek care from a VA provider while they are using their TRICARE benefit, TFL pays first, and Medicare pays nothing. In this situation, beneficiaries pay the TRICARE Select Calendar Year (CY) deductible, cost-shares and remaining billed charges. Alternatively, they may choose to use their VA benefit when seeing VA providers. To minimize out-of-pocket costs once they are covered by TFL, beneficiaries should seek care from providers who participate in both TRICARE and Medicare.